双镜种联合技术治疗复杂输尿管狭窄的疗效

目的：探讨双镜种联合技术处理复杂输尿管狭窄的可行性及临床效果。方法：回顾性分析2016年2月至2018年6月在中南大学湘雅医院运用该技术治疗的16例复杂输尿管狭窄患者的临床资料。16例患者均为医源性狭窄。术前患侧肾脏重度积水4例，中度积水7例，轻度积水5例。根据输尿管狭窄的具体位置及长度选择相应的手术方式。结果：所有患者顺利完成手术，无中转开放手术和脏器损伤。术后随访患者8~18个月，患者患侧肾积水均不同程度减轻，未发生输尿管再狭窄。结论：双镜种联合技术在术中能精准定位狭窄段、检验吻合效果、扩张炎性狭窄、提高远端输尿管狭窄行端-端吻合术的可能性，是一种治疗复杂输尿管狭窄疗效确切且安全可行的新技术。

Efficacy of laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique for treatment of complex ureteral stricture

Objective: To investigate the feasibility and clinical effects of the laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique for the treatment of complex ureteral stricture. Methods: The clinical data of 16 patients with complicated ureteral stricture treated by the laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique from February 2016 to June 2018 were retrospectively analyzed. All 16 patients were iatrogenic stenosis. There were 4 cases of severe hydronephrosis in the affected side, 7 cases of moderate hydronephrosis, and 5 cases of mild hydronephrosis. According to the specific location and length of the ureteral stricture, the corresponding surgical method was selected. Results: All patients successfully completed the operation without conversion to open surgery and organ injury. After the operation, the patients were followed up for 8–18 months. The hydronephrosis of all patients was relieved to varying degrees, and no ureteral restenosis occurred. Conclusion: The laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique can accurately locate the stenosis segment, test the anastomosis effect, expand the inflammatory stenosis, and improve the end-to-end anastomosis of the distal ureteral stricture, which is a new and effective technique for the treatment of complex ureteral strictures.